Survival and medical costs of non‐small cell lung cancer patients according to the first‐line treatment: An observational study using the Kyoto City Integrated Database

Author:

Shimamoto Tomonari1ORCID,Tateyama Yukiko1,Kobayashi Daisuke2,Yamamoto Keiichi3,Takahashi Yoshimitsu4,Ueshima Hiroaki56,Sasaki Kosuke4,Nakayama Takeo4,Iwami Taku1

Affiliation:

1. Department of Preventive Services Kyoto University School of Public Health Kyoto Japan

2. Agency for Health, Safety and Environment Kyoto University Kyoto Japan

3. Translational Research Institute for Medical Innovation Osaka Dental University Osaka Japan

4. Department of Health Informatics Kyoto University School of Public Health Kyoto Japan

5. Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences Kyoto University Kyoto Japan

6. Health Services Research and Development Center University of Tsukuba Ibaraki Japan

Abstract

AbstractBackgroundLung cancer is the primary cause of cancer mortality and non‐small cell lung cancer (NSCLC) accounts for the majority of lung cancer cases. New drug treatments have been developed since 2010 but there are concerns about the increase in medical costs. This study aimed to compare survival and medical costs among patients with NSCLC according to their initial treatment to estimate the impact of early NSCLC detection.MethodsPatients with primary NSCLC who filed insurance claims between April 2013 and March 2019 were identified using the Kyoto City Integrated Database. Patients were divided into two groups depending on their initial treatment: the resection group and drug or radiation group. The survival and medical costs were calculated.ResultsA total of 2609 patients with primary NSCLC were identified. Among them, 1035 patients underwent resection. The 5‐year survival was 75% for the resection group while below 25% for the drug or radiation group. At 6 months of survival, the median cumulative total cost was 2409 thousand yen (interquartile range [IQR] 1947–4012 thousand yen) in the resection group and 2951 thousand yen (IQR 1600–4706 thousand yen) in the drug or radiation group. At 4 years of survival, the cumulative median total cost was 5257 thousand yen (IQR 3808–8243 thousand yen) in the resection group and 10 202 thousand yen (IQR 4845–20 450 thousand yen) in the drug or radiation group.ConclusionsAs a first‐line therapy in newly diagnosed patients with NSCLC, surgical resection is associated with longer survival and lower medical costs than pharmacotherapy or radiotherapy.

Funder

Japan Society for the Promotion of Science

Publisher

Wiley

Subject

Pulmonary and Respiratory Medicine,Oncology,General Medicine

Reference25 articles.

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2. Foundation for Promotion of Cancer Research Cancer statistics in Japan2021.https://ganjoho.jp/public/qa_links/report/statistics/pdf/cancer_statistics_2021.pdf. Accessed 7 September 2022.

3. Cancer Information Service. Japan2022https://ganjoho.jp/reg_stat/statistics/stat/cancer/12_lung.html. Accessed 7 September 2022.

4. Society AC.Cancer Facts & Figures.2019https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf. Accessed 7 September 2022.

5. Non–Small Cell Lung Cancer: Epidemiology, Screening, Diagnosis, and Treatment

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